41
MI COVID RESPONSE DATA AND MODELING UPDATE NOTE: All data as of Jan. 16 unless otherwise noted
January 19, 2021
MI COVID RESPONSE DATAAND MODELING UPDATE
NOTE: All data as of Jan. 16 unless otherwise noted
Executive summaryMichigan has the 23rd highest number of cases (↑1) , 14th highest number of deaths (↓6), 46th highest case rate(↑2), and T23rd highest death rate (↓11) in the last 7 days (source: CDC COVID Data Tracker)
Michigan has the 34th highest hospitalization rate as a percent of total beds (↓1), and 16th highest number of COVID patients in the ICU (↓2) in last 7 days (source: Becker’s Hospital Review)
Case rates (287.5, ↑21.7) are plateaued for the third week in a row, percent positivity (7.6%, ↓2.2%) is decreasing after a week of increase, and testing has increased
10.7% of available inpatient beds are filled with COVID patients (↓1.4%) and state trends for COVID hospitalizations are decreasing
There were 480 deaths (↓55) between Jan 3 and Jan 9, and death rate is 6.9 deaths per million residents
Daily diagnostic tests increased to an average of 41.4K per day (↑7.3K) over the last week and the state rate is 3,972.9 tests/million/day (↑424.3)
512,906 doses reported to MDHHS of 1/19/21 (increase of 216,318 doses)
Science updates on the B.1.1.7 variant, herd immunity threshold and vaccination, and mobility
What we see today: • 5 states seeing increasing 1 week case trends (down vs. 38 last week)• 46 states (down vs. 47) with significant outbreaks (high/increasing cases, increasing/high
positivity increasing/high hospitalizations over 2 weeks (>100 per M)) • Arizona (653/M), Alabama, Georgia, Nevada, California have highest per capita
hospitalized patient numbers • Most rapid 1 week case growth: VA, ME, WA, NH, SC• Midwest:
– Wisconsin showing slight drop in hospitalizations (150/M), moderate drop in cases (445/M) – Indiana with slight decline in hospitalizations (354/M), and drop in cases (605/M)– Illinois showing slow decline in hospitalizations (264/M), cases dropping (460/M)– Ohio with declining hospitalizations (322/M) and slow drop in cases (620/M) – Michigan showing continued decline in hospitalizations (191/M) and decline in cases (275/M)
Comparison across states: Summary 1/18/21
3
COVID-19 Spread
Positivity has decreased to 7.6%, while testing has increased• Seven MERC regions now below 10%• Seven MERC regions have a decrease in positivity over the previous week
Case rates are plateaued – note that CDC trend indicator showing declines, but this indicator is fluctuating Plateaus are seen among most age groups, races, and ethnicities 0-29 age group may be increasing
Nearly a third of cases have race and ethnicity missing Number of active outbreaks is down 12% from previous week Number of reported school outbreaks decreased again since last week (50 to 40) with only outbreaks in high schools
having an increase
5
Confirmed and probable case indicatorsTable Date: 1/16/2021 (7 days from date table was produced: 1/9/2021)
Risk levels
Low A B C D E
Cases Positivity
6
Recent statewide trends
Source: https://mistartmap.info/
Positivity: 3.8%Cases: 281.7Hosp. rate: 7.1%
Regional breakdown: Cases, hospitalization rate, and positivity
Positivity: 7-day average positivity, %Cases: 7-day average cases per millionHosp. rate: 7-day average hospitalization rate, %
Daily hospitalization rate, %
Daily cases per million
Positivity, %
7-day average Daily values
Statewide trends
Current: 287.5
Current: 10.7%
Current: 7.6%
Positivity: 8.0%Cases: 321.5Hosp. rate: 12.5%
Positivity: 8.0%Cases: 281.7Hosp. rate: 6.2%
Positivity: 8.2%Cases: 310.8Hosp. rate: 9.8%
Positivity: 8.0%Cases: 306.6Hosp. rate: 14.2%
Positivity: 7.5%Cases: 255.5Hosp. rate: 10.6%Positivity: 8.6%
Cases: 347.5Hosp. rate: 12.2% Positivity: 10.9%
Cases: 444.3Hosp. rate: 13.5%
0
200
400
600
800
1000
10/19 11/2 11/16 11/30 12/14 12/28 1/11
0.0%
5.0%
10.0%
15.0%
20.0%
10/19 11/2 11/16 11/30 12/14 12/28 1/11
0%
5%
10%
15%
20%
10/19 11/2 11/16 11/30 12/14 12/28 1/11
7
Positivity by county, 1/8-1/14
Source: SEOC Testing Results – Excluding MDOC
Last week, 1/1-1/7
Average positivity per day
<3%
3-7%
7-10%
10-15%
15-20%
>=20%
# of counties
Updates since last week:21 of 83 counties saw double digit positivity in the last week (25 county decrease)
4
26
32
18
2
1
3
13
21
37
6
3
This weekLast week*
8
Confirmed COVID-19 cases by report date: State of Michigan
Confirmed cases reported on prior day (7-day rolling average)
The number of weekly reported cases to public health is remaining about the same
In the last week, 14,502 cases reported
Source: MDHHS – Michigan Disease Surveillance System
Number of cases7 day rolling average
2,694
1,738
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
10,000
10/21 10/28 11/4 11/11 11/18 11/25 12/2 12/9 12/16 12/23 12/30 1/6 1/13
9
COVID-19 cases by onset date: State of Michigan
Cumulative confirmed and probable cases, by date of onset of symptoms
New confirmed and probable cases , by date of onset of symptoms
Note: Cases information sourced from MDHHS and reflects date of onset of symptoms (refers to lab-confirmed cases). Case spike on 5/12 is a result of batch of test results, not all of which have onset date of symptoms completedSource: MDHHS – Michigan Disease Surveillance System
Updates since last week:• Cases are now at a plateau • Current statewide daily case rate remains more than 1.5x the highest risk level (risk level E is 150 cases/million)• More than half of regional case rates are 2x the risk level E threshold
0
100000
200000
300000
400000
500000
600000
3/1 4/1 5/1 6/1 7/1 8/1 9/1 10/1 11/1 12/1 1/10
100020003000400050006000700080009000
1000011000
3/1 4/1 5/1 6/1 7/1 8/1 9/1 10/1 11/1 12/1 1/1
10
Age group: average new daily cases
Note: Cases information sourced from MDHHS and reflects date of onset of symptoms Source: MDHHS – Michigan Disease Surveillance System
30-490-29
70+50-69
Daily new confirmed and probable cases per million by age group (7-day rolling average)
• 30-49 age group continues to have the highest cases per million• 0-29 age group has continued to increase (200 to 275) while other age groups have plateaued or are decreasing
0
200
400
600
800
1000
3/1 3/15 3/29 4/12 4/26 5/10 5/24 6/7 6/21 7/5 7/19 8/2 8/16 8/30 9/13 9/27 10/11 10/25 11/8 11/22 12/6 12/20 1/3
11
Note: Cases information sourced from MDHHS and reflects date of onset of symptoms; note that Multiple Races, Other, and Unknown race/ethnicity are not included in calculations
Daily new confirmed and probable cases per million (7 day rolling average) by race category
Average daily new cases per million people by race
Source: MDHHS – Michigan Disease Surveillance System
American Indian/Alaska NativeAsian/Pacific Islander
Black/African AmericanWhite
• Cases per million continue plateau for most racial groups• 30% of all cases represent unknown, multiple, or other races
0
100
200
300
400
500
600
3/1 3/15 3/29 4/12 4/26 5/10 5/24 6/7 6/21 7/5 7/19 8/2 8/16 8/30 9/13 9/27 10/11 10/25 11/8 11/22 12/6 12/20 1/3
12
Note: Cases information sourced from MDHHS and reflects date of onset of symptoms; note that Multiple Races, Other, and Unknown race/ethnicity are not included in calculations
Daily new confirmed and probable cases per million (7 day rolling average) by ethnicity category
Average daily new cases per million people by ethnicity
Source: MDHHS – Michigan Disease Surveillance System
Hispanic or Latino Not Hispanic or Latino
• Cases per million are plateauing for both Hispanic/Latinos and non-Hispanic/Latinos• 26% of all cases have an unknown ethnicity reported
0
100
200
300
400
500
600
700
3/1 3/15 3/29 4/12 4/26 5/10 5/24 6/7 6/21 7/5 7/19 8/2 8/16 8/30 9/13 9/27 10/11 10/25 11/8 11/22 12/6 12/20 1/3
13
Number of outbreak investigations by site type, week ending Jan 14
Pre-decisional, for discussion only Draft
Total number of active outbreaks is down 12% from previous week
Following LTCs, the greatest number of new outbreaks were reported in manufacturing/ construction (23), retail (15), healthcare (11), religious services (9), social gatherings (9) and K-12 schools (8).
LHDs reported new outbreaks in all settings except agriculture/food processing, shelters, and outdoor community exposure
Site type Outbreaks by ongoing/new classification, #
Source: LHD Weekly Sitreps
1. Based on a setting’s level of control and the extent of time patrons/residents spend in the particular setting, different settings have differing levels of ability to ascertain whether a case derived from that setting
NOTE: Many factors, including the lack of ability to conduct effective contact tracing in certain settings, may result in significant underreporting of outbreaks. This chart does not provide a complete picture of outbreaks in Michigan and the absence of identified outbreaks in a particular setting in no way provides evidence that, in fact, that setting is not having outbreaks.
Visibility1
Easier to identify outbreak Harder to identify outbreak
00176129
1211
1925
202832
5655
87394
01101052911948
1115
2337
01277
121414202026293240
6770
110431
*COMMUNITY EXPOSURE - OUTDOOR*COMMUNITY EXPOSURE - INDOOR
*PERSONAL SERVICES *SHELTERS
*RESTAURANTS AND BARSAGRICULTURAL /FOOD PROCESSING
CHILDCARE/YOUTH PROGRAMOTHER
*REL IGIOUS SERVICESCOLLEGE/UNIVERSITY
CORRECTIONS*SOCIAL GATHERING
OFFICE SETTINGK - 12 SCHOOLHEALTHCARE
*RETAILMANUFACTURING, CONSTRUCTIONSNF/LTC/OTHER ASSISTED L IV ING
Ongoing New Total
774 128 902TOTAL
14
K-12 school outbreaks, recent and ongoing, week ending Jan 14
# Ongoing - Excluding New # New
6 4-12
2 2-8
17 5-19
1 4-4
2 6-10
10 2-16
1 2-2
40 2-19
1 5-5
19 4-19
7 1-16
2 3-7
12 10-17
Range of cases per outbreak
Number of outbreaks
Range of cases per outbreak
Grade level Number of reported cases, #
Region Number of reported cases, #Number of outbreaks
33
4
8
125
6
84
0
5
265
15
0
2
21
10
5
2
0
55
Region 3
Region 8
Total
Region 2n
Region 1
Region 2s
Region 5
Region 6
Region 7
110
69
73
15
267
23
4
28
0
55
Administrative
Pre-school - elem.
High school
Jr. high/middle school
Total
Source: LHD Weekly Sitreps
Many factors, including the lack of ability to conduct effective contact tracing in certain settings, may result in significant underreporting of outbreaks. This chart does not provide a complete picture of outbreaks in Michigan and the absence of identified outbreaks in a particular setting in no way provides evidence that, in fact, that setting is not having outbreaks.
40 3-19
# Ongoing - Excluding New # New
Number of reported outbreaks decreased since last week (50 to 40) including reductions in Middle/Jr High (12 to 7), Pre K-Elementary (22 to 19), and Administrative (6 to 3). Only High Schools saw an increase in the number of reported outbreaks (10 to 12).
COVID-19 and Healthcare Capacity and COVID Severity
Hospitalizations and ICU utilization are decreasing COVID-like illness (CLI) continues with downward trend Hospitalizations down 52% since December 1st peak ICU occupancy declined 7% over last week All regions at or below 20% of Adult ICU beds with patients positive for COVID-19
Current deaths are a lagging indicator of cases, but the number of deaths have declined for fourth consecutive week Decreases in deaths seen among most ages, ethnicities, and races
Michigan Trends in Emergency Department Visits for COVID-19-Like Illness (CLI)
Source: https://covid.cdc.gov/covid-data-tracker/#ed-visits
Statewide Hospitalization Trends: Total COVID+ Census
17
Hospitalization Trends 7/1/2020 – 1/18/2021Confirmed Positive
This week, total COVID+ census in hospitals is down 12% from the previous week and 52% down from the December 1 peak.
Confirmed Positive
PUI
Hospitalized COVID Positive Long Term Trend (beginning March)
Statewide Hospitalization Trends: Regional COVID+ Census
18
Hospitalization Trends 8/1/2020 – 1/18/2021Confirmed Positive by Region
Most regions are showing decreasing or flat trends in COVID+ hospital census.
Regions 7 and 8 are up slightly this week, though total volume hospitalized in these regions remains very low.
Region 2NRegion 2S
Region 3
Region 5
Region 6
Region 1
Region 7Region 8
Region Trend from Last Week
COVID+ Hospitalizations /
MM
Region 1 -33% 124/M
Region 2N -8% 230/M
Region 2S -8% 223/M
Region 3 -15% 278/M
Region 5 -14% 145/M
Region 6 -14% 155/M
Region 7 9% 98/M
Region 8 3% 119/M
Statewide Hospitalization Trends: ICU COVID+ Census
19
Hospitalization Trends 8/1/2020 – 1/18/2021Confirmed Positive in ICUs
The census of COVID+ patients in ICUs have declined over the past week by 7% from the previous week.
Regions 2N, 7, 8 saw some increases in ICU census this week although total census in regions 7+8 is low.
No regions have >20% of ICU beds occupied by COVID+ patients.
Confirmed Positive in ICU
Region Adult COVID+ in ICU (% Δ from
last week)
Adult ICU Occupancy
% of Adult ICU beds COVID+
Region 1 33 (-28%) 91% 17%
Region 2N 92 (+19%) 80% 16%
Region 2S 117 (-19%) 80% 15%
Region 3 72 (-4%) 88% 20%
Region 5 16 (-27%) 78% 11%
Region 6 60 (-10%) 64% 17%
Region 7 31 (+15%) 72% 17%
Region 8 11 (+57%) 72% 19%Hospital bed capacity updated as of 1/15
20
COVID-19 deaths by date of death: State of Michigan
Cumulative confirmed and probable deaths, by date of death
New confirmed and probable deaths , by date of death
Note: Death information sourced from MDHHS and reflects date of death of confirmed and probable cases.Source: MDHHS – Michigan Disease Surveillance System
Draft
Updates since last week:Although deaths are a lagging indicator of cases, the number of deaths have declined for four weeksThe current number of deaths is more than 5x the number of deaths in early October
Pre-decisional, for discussion only
0
3000
6000
9000
12000
15000
3/1 4/1 5/1 6/1 7/1 8/1 9/1 10/1 11/1 12/1 1/10
20
40
60
80
100
120
140
160
180
200
3/1 4/1 5/1 6/1 7/1 8/1 9/1 10/1 11/1 12/1 1/1
21
Note: Death information sourced from MDHHS and reflects date of death of confirmed and probable cases.
Total new confirmed and probable deaths by age group (past 30 days, ending 1/9/2021)
Daily new confirmed and probable deaths per million by age group (7 day rolling average)
0-1920-29 50-59
40-49 70-7980+
Average and total new deaths, by age group
Source: MDHHS – Michigan Disease Surveillance System
7 18 38108
334
591
1,139
70-7940-490-19 60-6920-29 30-39 50-59 80+
1-5
8% of deaths below age sixty30-39 60-69
Pre-decisional, for discussion only
0
25
50
75
100
125
150
175
10/1 10/15 10/29 11/12 11/26 12/10 12/24 1/7
22
Note: Multiple Races, Other, and Unknown race/ethnicity are not included in calculationsSource: MDHHS – Michigan Disease Surveillance System
Average daily new deaths per million people by race
American Indian/Alaska NativeAsian/Pacific Islander
Black/African AmericanWhite
• Deaths per million continue to decrease among racial groups• Whites have the most reported deaths per capita• The large fluctuation seen among American Indian/Alaskan Native is due to small population size
Pre-decisional, for discussion only
0
2
4
6
8
10
12
14
16
7/1 7/8 7/15 7/22 7/29 8/5 8/12 8/19 8/26 9/2 9/9 9/16 9/23 9/30 10/7 10/14 10/21 10/28 11/4 11/11 11/18 11/25 12/2 12/9 12/16 12/23 12/30 1/6 1/13
23
Note: Multiple Races, Other, and Unknown race/ethnicity are not included in calculationsSource: MDHHS – Michigan Disease Surveillance System
Average daily new deaths per million people by ethnicityHispanic or Latino Not Hispanic or Latino
• Deaths are a lagging indicator of cases• Deaths per million continue to decrease for Hispanic/Latino and non-Hispanic/Latino• There are fewer Hispanic/Latino deaths per million than non-Hispanic/Latino but these are not adjusted for confounders
Pre-decisional, for discussion only
0
2
4
6
8
10
12
14
16
7/1 7/8 7/15 7/22 7/29 8/5 8/12 8/19 8/26 9/2 9/9 9/16 9/23 9/30 10/7 10/14 10/21 10/28 11/4 11/11 11/18 11/25 12/2 12/9 12/16 12/23 12/30 1/6 1/13
Michigan’s National Ranking for Deaths per 100,000Including DC and NYC
0
5
10
15
20
25
30
35
40
45
50
3/24 4/7 4/21 5/5 5/19 6/2 6/16 6/30 7/14 7/28 8/11 8/25 9/8 9/22 10/6 10/20 11/3 11/17 12/1 12/15 12/29 1/12
Rank
ing
Source: CDC COVID data tracker and U.S. Census
Pre-decisional, for discussion only
Fewer deaths compared to other states
More deaths compared to other states
How is public health capacity?
Testing volume has increased slightly from last week to 49,466• 14.9% are antigen tests• Testing by county ranges from 900 to 11,000 daily tests per million residents
Case investigations improving after the holiday dip• Consistent proportion of cases interviewed have a source of known infection (indicating community spread)• Among those cases interviewed, there continues to be a low proportion of those quarantining when their symptoms
begin
26
`
Source: MDSS/Michigan Medical Advantage Group, MDHHS, testing labs
Testing Overview
49,466 (↑11,875)Rolling 7-day average daily diagnostic tests reported to MDHHS
14.9% are antigen tests over the past week
- 3.5% positivity in antigen tests
27
`
Source: MDSS/Michigan Medical Advantage Group, MDHHS, testing labs
Daily diagnostic tests, by message date
-
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000Last 90 Days Tests By Test Type and Message Date
Total Diagnostic Tests Total Antigen Tests 7 day moving average, diag. tests
49,466 (↑11,875)Rolling 7-day average daily diagnostic tests reported to MDHHS
14.9% are antigen tests over the past week
- 3.5% positivity in antigen tests
28
Case investigation complete? Known source of infection? Already quarantining at timeof symptom onset?
Case investigation complete? Known source of infection? Already quarantining at timeof symptom onset?
01/02-01/08 Case report form information 01/09-01/15 Case report form information
14%
43%
45%
26%
33%
42%
9,147
9,147(76%)
12,050
New Case Investigation Metrics
10,481(49%)
21,374
42%28%
34%
24%
58%
14%10,481 10,481
Yes No Not answered
New Communicable Disease metrics slightly increased since last week:• 43% of investigated cases having a known source (42% last week, 46% week prior)• 26% of investigated cases noting that they were quarantining before symptoms (28% last week)
Source: MDHHS – Michigan Disease Surveillance System
10,893
2,903 9,147
COVID-19 Vaccination and Serology
Seroprevalence of COVID in Michigan is 8.8%• On Monday, January 11, CDC published national data (through November 2020)• Michigan faired relatively better than neighboring states of Wisconsin, Illinois, and Ohio• More individuals have likely been infected than have been identified through disease surveillance and reporting• Individuals not identified were possibly asymptomatic or never received medical care for COVID-19• Younger age is associated with a higher likelihood of seroprevalence
COVID-19 Vaccination• 5.4% of Michiganders have first dose of vaccine (up from 3.2 last week)• 512,906 doses reported to MDHHS, including 437,027 first doses and 75,879 second doses
Nationwide Commercial Laboratory Seroprevalence Survey
Source: https://covid.cdc.gov/covid-data-tracker/#national-lab
• The estimated prevalence, or proportion of individuals who have ever been infected with SARS-CoV-2, as measured by antibodies in the blood
• Current CDC data through the end of November 2020
• Despite the surge of cases in Michigan during the early months of the epidemic, Michigan has faired relatively better than neighboring states
Michigan Commercial Laboratory Seroprevalence Survey
Source: https://covid.cdc.gov/covid-data-tracker/#national-lab
0%
2%
4%
6%
8%
10%
August November
Michigan Commercial Laboratory Seroprevalence Survey – Age and Sex Distributions
Doses Shipped and Administered
Data as of : 17-Jan-21 19-Jan-21 18-Jan-21 18-Jan-21Enrolled
ProvidersDoses
ShippedTotal Doses
Administered 1st dose 2nd dose 1st dose Coverage, 16+
Michigan 1,615 844,125 512,906 437,027 75,879 5.4%Federal LTC Program 245,100 Total with LTC Distribution 1,089,225
Graphic based on 1/18/21
Long Term Care Federal Partnership
Federal Long-Term Care Facility (LTCF) Pharmacy Partnership Program Data as of 1/16/21
Pharmacy Phase
Activation Date
Facilities Assigned
First Clinic
Complete
% First Clinic
Complete
Total Vaccines
Administered(Residents &
Staff)
Additional Clinics
Scheduled Over
Next 7 Days (includes
today)CVS Part A (Skilled Nursing) 12/28/2020 269 269 100% 23317 0CVS Part B (Other LTCF) 01/04/2021 717 331 46% 14781 210Walgreens Part A (Skilled Nursing) 12/28/2020 146 126 86% 11396 22Walgreens Part B (Other LTCF) 01/04/2021 3852 251 7% 7290 422
Totals 4984 977 56784 654
Science Round Up
MDHHS Bureau of Laboratories has identified B.1.1.7 variant in sample from Washtenaw County, expected to be elsewhere in Michigan• B.1.1.7 Variant is not expected to impact effectiveness of COVID-19 vaccines• Masking, social distancing and hand washing continue to be crucial• B.1.1.7 Variant transmits between humans more easily, so case rates may increase
Safely achieving herd immunity through vaccination can reduce or eliminate spread of disease from person to person• A more transmissible B.1.1.7 variant means a higher herd immunity threshold is likely
Mobility Update• Most recent data shows some return toward baseline mobility patterns, particularly for non-essential visits
SARS-CoV-2 Genetics • Viruses infect human cells because they lack the ability to replicate themselves in order to survive
• When the virus replicates it can be error prone and introduce mutations
• Most mutations will not affect the virus due to:
• Minimal change in protein
• Virus is no longer viable due to damaged proteins
RNA (Genetic material/
Nucleic Acid)
RNA polymerase(replicationmachinery)
• B1.1.7 variant first identified in UK and has now been found in most US states; including Michigan
• The B.1.1.7 variant does not give current indication of impacting vaccination or treatment options
• Does lead to increased ability to transmit between people
• Mitigation strategies of masks, hand washing, distancing are all effective at prevention
1. RNA tells proteins to form2. Proteins fold and make things happen in a cell3. Damaged proteins can be bad for the virus or for the human
Projecting the impact of the B.1.1.7 variant
• Rt over time in Michigan—recent data has been ~0.9
• UK data suggests Rt for B.1.1.7 variant is 1.5x higher (dashed line)
• Project impact of B.1.1.7 assuming we move to 1.5x Rt over 1 month (orange)
Data Sources: rt.live, MDSS data, Vöhringer et al.
COVID-SIM projected vs. actual daily deaths
• November COVID-SIM projection (assumes conditions stay the same) vs. actual daily deaths
• Peak projected daily deaths range ~125-250
• Actual peak daily deaths ~150
Pause to Save Lives
Pause to Save Lives
Source: MDSS data, COVID-SIM
Unacast mobility patterns in MI
unacast social distancing scoreboardhttps://www.unacast.com/covid19/social-distancing-scoreboard
Change in average mobility
Change in non-essential visitsMost recent data shows some return toward baseline mobility patterns, particularly for non-essential visits(data through 1/14/21)
Difference in encounter density
Michigan.gov/Coronavirus
QUESTIONS?QUESTIONS?
